Matthew Jordan Nykiel, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A120256 Issued in CA

Practice address

1113 Alta Ave Ste 103
Upland, CA 91786-2803

Phone

(949) 429-0890

Fax

(949) 340-0696

NPI assigned

Jul 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1063612802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 ALTA AVE STE 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862803",
            "telephone_number": "949-429-0890",
            "fax_number": "949-340-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 ALTA AVE STE 103",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862803",
            "telephone_number": "949-429-0890",
            "fax_number": "949-340-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYKIEL",
        "first_name": "MATTHEW",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME119656",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A120256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nova Home Hospice Inc.
• Nova Homehealth, Inc.
• Adam J Novak, M.D.
• Nurtured Minds
• Nutrition Counseling Plus
• Melissa O'Banion, PA-C
• Robert Forrest O'Dell, DDS
• Patrick John Occhiato, LMFT
• Rommel Ocfemia
• Glenn Anton Ocker, D.P.M.

• Plastic and Reconstructive Surgery Physician in Upland, CA
• Providers in Upland, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.